The ever-expanding diabetes epidemic in the US and around the world is fueled by lifestyle choices as much as anything else. While many people are genetically prone to the disease, others increase risk by getting too little exercise and too much sugar and fat in the diet. The findings of a wide-scale long-term study of dietary impact indicate how important it is for people who regularly consume sweet beverages to replace just one serving of a sweet beverage a day to dramatically reduce the risk for type 2 diabetes whether or not it runs in the family.

Dr. Nita Forouhi led the study from the University of Cambridge, where she is a member of the Medical Research Council (MRC) Epidemiology Unit. She and her research team analyzed beverage diaries from older adults then followed them almost 11 years to see who developed type 2 diabetes.

Beverages Under Study

The researchers worked with 25,639 adult male and female residents of Norfolk, United Kingdom, who each submitted a 7-consecutive-day food and beverage diary between 1993 and 1997 as part of the European Prospective Investigation into Cancer and Nutrition (EPIC). All study participants were between 40 and 79 years of age and none exhibited baseline symptoms of diabetes when they were enrolled in the study.

Forouhi focused on beverages, categorizing them as:

  • Sugar-sweetened beverages/soft drinks, sweetened milk beverages, sweetened coffee or tea.
  • Artificially sweetened beverages
  • Unsweetened beverages — water, coffee, tea
  • Fruit juices

Diabetes Outcomes

During the 11-year follow-up period, 847 (11.8%) of the study participants were diagnosed with type 2 diabetes. When Forouhi’s research team factored in the impact of waist girth and body mass index of the now-diabetic study participants, they found the greatest risk of developing type 2 diabetes was in the study subjects who routinely consumed sugar-sweetened soft drinks and sugar-sweetened milk drinks.

Beverage consumption affected the study participants as follows:

  • 22% increased risk of type 2 diabetes for every extra serving per day of soft drinks, sweetened milk beverages, and even artificially sweetened diet beverages.
  • The excess pounds of obese people who drank artificially sweetened beverages were probably more to blame for increased diabetes risk than diet beverages.
  • No links were found between diabetes and consumption of fruit juices or unsweetened tea and coffee.

If the diabetic study participants had replaced one serving of sweet beverage per day with water or unsweetened tea or coffee, they would have reduced diabetes risk by:

  • 14% if it replaced a serving of soft drink.
  • 20% to 25% if it replaced a sweetened milk beverage.

For every 5% of excess calories from sugar in a person’s daily diet, his or her risk of diabetes rose by 18%.

Hidden Sugars

As the general population is becoming better educated on the dangers of excess sugar consumption in both foods and beverages, food and beverage manufacturers are using more alternative names to hide sugar on ingredients labels. Strong lobbying efforts from the American sugar industry has prevented food manufacturers from listing exactly how much sugar, by any alias, is in any food or beverage but food labels list ingredients in descending order by weight. The first ingredient is the one that weighs the most in a serving of food or beverage; the last ingredient weighs the least. In other words, the closer any sugar is to the beginning of the ingredients list, the more sugar the food or beverage contains.


  1. Forouhi, Nita G, et al. "Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages." Diabetologia (2015). Springer. Web. 8 May 2015.
  2. "Added Sugar in the Diet." Harvard TH Chan School of Public Health. The President and Fellows of Harvard College, n.d. Web. 8 May 2015.